Legislation

The Charleston County Medical Society’s legislative priorities for 2019:

Repeal the State Certification of Need and Health Facility Licensure Act

Exempt doctors from non-compete clauses as a condition of employment

Give doctors a state income tax deduction for charitable care

Our legislative priorities for the state legislature will expand access and lower the cost of high-quality health care by providing more choices for all South Carolinians.

Repeal the State Certification of Need and Health Facility Licensure Act

The Problem:South Carolina “certificate-of-need” (“CON”) laws require that permission be obtained from a state (or state-authorized) agency to construct new healthcare facilities, expand existing ones, or offer certain healthcare services.Currently, hospital systems in South Carolina have a virtual monopoly over healthcare in the state. State law requires that a “need” be proven before certain medical facilities (surgery centers, facilities for addiction, birthing centers and others) can be built. This law is known as the State Certification of Need and Health Facility Licensure Act (CON). As a result of CON, there are no alternatives outside of a hospital system for patients needing routine surgical procedures (breast biopsy, carpal tunnel release, hernia repair, for example). Systems that already have secured CONs spend years and millions of dollars trying to keep any other entities from building smaller, potentially more efficient, less expensive and consumer sensitive facilities. Because of CON, prices stay high and South Carolinians have less choices.

The Solution:

The elimination of CON requirements would expand access, drive down prices and increase the quality of health care in South Carolina. With more marketplace competition in the health care industry, patients would ultimately be empowered to make choices that best serve them and their pocketbooks.

Exempt doctors from non-compete clauses as a condition of employment

The Problem:

An overwhelming majority of doctors, nurses, and health care employees are required by their employers to sign legally binding non-compete agreements. Once signed, this means that upon leaving their current place of employment, that healthcare worker cannot become an employee of a competing practice or start a new practice. The agreements are typically in place for a specific allotment of time and designate specific geographic boundaries.

Enforcing non-compete clauses limits patients’ access to medical practitioners purely for the benefit of the employing system. Doctors that sign these agreements are unable to participate in new ventures that would benefit patients. The non-compete takes a doctor’s greatest professional assets — knowledge and skills earned over years of hard work— and turns them into a liability because they cannot take those assets elsewhere upon leaving their firm. Further, non-compete clauses can cause patients to lose access to their physicians and limit patients’ free choice of doctors.

The Solution:

Exempting doctors from non-competes, as half of the other states do, would increase competition in the marketplace, lower health care costs and expand access in South Carolina.

Give doctors a state income tax deduction for charitable care

The Problem:

The percentage of physicians who provide pro bono care has been in steady decline. With decreasing reimbursement, physician practices function with smaller financial margins, which in turn limit the amount of free care they are able to provide.

Those who want to provide that care are further limited by the unavailability of non-hospital owned facilities. Ironically, employed doctors who find themselves caring for indigent patients, and for which the hospitals are compensated and receive tax benefits for “charity care,” don’t receive special consideration.

The Solution:

Allow state income tax deductions to doctors who provide charitable care to incentivize doctors to provide more care to the disenfranchised.